Patient Forms

New patients will need to fill out several forms before therapy can begin. To make the process as smooth and efficient as possible, we provide the most important documents as downloads right here on our website.

 

Find out which forms you need to submit, select the appropriate download link and return the completed documents to our practice either in person or as a scanned PDF file via e-mail. Naturally, all forms are also available at the practice; however, filling them out in advance saves time.

If you are unsure which forms to fill out, don't hesitate to contact us.

New Client Information Form
GLT New Ct Info Form.pdf
Adobe Acrobat document [32.9 KB]
Informed Consent
GLT Informed Consent.pdf
Adobe Acrobat document [62.3 KB]
Informed Consent Parent For Child
GLT Informed Consent Parent.pdf
Adobe Acrobat document [50.0 KB]
Authorization To Exchange Confidential Information
Auth to exchange info.pdf
Adobe Acrobat document [12.0 KB]
Credit Card Authorization Form
GLT Credit Card Auth Form.pdf
Adobe Acrobat document [32.2 KB]

Note: You will need Adobe(r) Reader(r) to view PDF files. If you do not have it, you can download it for free.